Supporting Rural Health Centres in Ethiopia

Meeting the health extension workers

Picture 1:HEW from Seka

The Health Extension Workers (HEW) are the community health agents working on health education, prevention and promotion of health in the community. We have used this opportunity provided by the health care system to reach rural people and raise awareness among their community on some of the risk factors of non-communicable diseases as well as identifying symptomatic cases, screening for raised blood pressure and also tracing patients who have been lost follow up at Health Centres. These are early days for our developing the skills of the HEWs; we hope to report on their progress in the community as our work with them becomes more mature. But we are delighted to enlarge the range of care for rural patients; it has never been done before and so is a significant step forward for training.

Picture 2: HEW from Serbo 

Semira is a HEW from Shebe catchment area, sitting in the middle in picture no 2. While looking at an educational video of different seizure types she remembered a case from her village. This was her description of what apparently looked like an absence seizure.

‘A 10 year old boy has an attack of absence with looking upward and showing the white of his eyes. He continues to do whatever he has been doing, like walking or eating, but appears to be “absent” and thus he continues to do whatever he has been doing as if never interrupted ’

Picture 3:HEW from Shebe area

The health extension workers are given a three days orientation about features of epilepsy, diabetes, hypertension and heart disease. They are also oriented on how to deliver educational messages on risks, preventive measures and how to deliver lifesaving first aid in case of crisis until appropriate referral can be arranged.

Picture 4:HEW from Omonada area

Picture 5 Community involvement, a new approach for chronic disease prevention and care

Health extension workers in Gondar area are now important and recent members of the team (specialist doctors, nurses, pharmacists, laboratory technicians) caring for chronic disease patients. These are a contemporary health cadre in the Ethiopian health care system primarily engaged in preventive interventions. They are recruited from among their community for a short training and then they return to their home area which is the reason for their high commitment. They have thus been responsible for a number of high impact outcomes in vaccination and in making people aware of their access to health care. Most of them aspire to develop a career in health care such as nursing, pharmacy and environmental health worker.

The HEWs are also be useful for increasing the awareness of the community about chronic non communicable diseases. They can help in early detection, prompt referral and tracing of those who have been lost to follow up. In the chronic disease programs in Jimma and Gondar we are reaching out to HEWs and orienting them on the most important Non Communicable Diseases declared by Ministry of health (diabetes, heart and respiratory diseases) and also in epilepsy. The Health Centre nurse second from far left (brown shirt) would receive referrals from her team of HEWs, confirm diagnosis and start treatment according to standardized protocols and training delivered to her at Gondar University Hospital Chronic disease clinic.